1. The Field of the Invention
The present invention relates generally to an apparatus for visualization of endoscopic and borescopic fields, in minimally invasive surgical (MIS) procedures, general or diagnostic medical or industrial procedures using endoscopes or borescopes, respectively. More particularly, embodiments of the invention relate to use of portable and completely disposable endoscopic access device as a pluggable and removable vision systems in endoscopic procedures, that are completely disposable, with means of solid state illumination, image capture, equipped with an access channel, and means for suction and delivery of medication or lubricant to the endoscopic field. The device to be externally plugged into a control unit for display of endoscopic video, where the control unit provides power to the medical device, and controls and displays the visual data, through Universal Serial Bus cabling that can be disposed of along with the disposable medical access device.
2. The Relevant Technology
Endoscopy is used in both diagnostic and surgical procedures. Currently, MIS procedures, as opposed to open surgical procedures, are routinely done in almost all hospitals. Minimally invasive techniques minimize trauma to the patient by eliminating the need to make large incisions. This both reduces the risk of infection and reduces the patient's hospital stay. Endoscopic procedures in MIS use different types of endoscopes as imaging means, giving the surgeon an inside-the-body view of the surgical site. Specialized endoscopes are named depending on where they are intended to look. Examples include: cystoscope (bladder), nephroscope (kidney), bronchoscope (bronchi), laryngoscope (larynx+the voice box), otoscope (ear), arthroscope (joint), laparoscope (abdomen), gastrointestinal endoscopes, and specialized stereo endoscopes used as laparoscopes or for endoscopic cardiac surgery.
The endoscope may be inserted through a tiny surgical incision to view joints or organs in the chest or abdominal cavity. More often, the endoscope is inserted into a natural body orifice such as the nose, mouth, anus, bladder or vagina. Laryngoscopes are used in Endo-Tracheal intubation, a common procedure performed on all patients under anesthesia and in emergency situations where a flexible plastic catheter or Endotracheal Tube (ET tube) is placed into the trachea to protect the airway and provide a means of mechanical ventilation. There are three basic types of endoscopes: rigid, semi-rigid, and flexible. The rigid endoscope comes in a variety of diameters and lengths depending on the requirements of the procedure. Typical endoscopic procedures require a large amount of equipment. The main equipment used in conjunction to the visual part of the endoscopic surgery are the endoscope body, fiber optics illumination bundles, illumination light source, light source controller, imaging camera, camera control module, and video display unit.
FIG. 1 depicts a direct laryngoscope 100 with a handle 104 containing batteries for power, and a curved Macintosh type blade 102, equipped with fiber optic or lamp illumination 106 that is used for manual direct visualization of the larynx. The Direct laryngoscope, where the practitioner obtains manual visualization of the vocal cords and tracheal opening to perform intubation, is used by anesthesiologists, on patients under anesthesia for routine airway management procedures. Where difficult airway is suspected or encountered however, more sophisticated and expensive video intubation products are used.
Due to non-portability and expensive nature of the video laryngoscope and intubation devices, most emergency intubations are also performed with direct laryngoscopy with poor success rates due to, the emergency nature of the case, unpredictability of the airway, and lack of practice by the non-anesthesiologist staff performing the procedure.
Patients that are awake during the procedure present emergency staff with more challenges, where involuntary reflexes and muscle spasms could make the tube insertion into the tracheal opening very difficult. The possibility of cuts and tissue damage to soft tissue in the mouth, throat, and vocal cord, increases with multiple attempts and forced attempts especially during emergency situations.
The cost of ownership of the video intubation devices also prohibits most hospitals in having ample equipment ready for use in all operating rooms, emergency rooms and crash carts. In emergency cases the manual visualization is at times impossible with the patient's position, circumstances that could involve other injuries such as C-Spine injury where the patient cannot be moved.
Video intubation devices currently available are also only partially disposable where a disposable cover or sheath is used to protect the reusable part of the visualization system. Various expensive visualization devices, capture electronics, rechargeable means for power, and small LCD displays mounted on the video intubation device need to be separated after use and cleaned. Improper cleaning process in these devices can lead to cross contamination and risk of infection for the patient.
Portable video intubation devices and as well as direct laryngoscopes are powered by portable batteries, within the device, where battery replacement and recharging is necessary for proper operation.
Other completely disposable intubation devices have manual visualization or allow for only a small display mounted on the intubation device itself, where shared viewing of the intubation process is not possible. In addition, most video intubation devices use analog video capture devices, where storage, transfer of the video data cannot be done without separate and secondary Analog to Digital conversion of data. Current video intubation devices are closed systems with limited process, transfer, sharing, and storage capability.